BRUIN BASEBALL HITTING ACADEMY
Makes Checks Payable to:
Western Branch Baseball
NAME OF CAMPER: _____________________________________________________
PHONE NUMBER (HOME): _______________________________________________
CELL NUMBER: ________________________________________________________
EMERGENCY CONTACT (NAME): ________________________________________
(PHONE NUMBER): _________________________________________
MEDICATION ALLERGIC TO: ____________________________________________
MEDICATION BEING TAKEN NOW: _______________________________________
RELEASE/MEDICAL INFORMATION: All campers must have insurance in the
event that the camper has an injury or illness while attending the hitting academy. Each
camper will be responsible for their own medical expenses if such an emergency occurs.
By signing this medical release form, no staff member or player of Western Branch High
can be hold liable for any injury that may occur during the Bruin Hitting Academy.
Please complete the following information below:
Insurance Carrier: ________________________________ Policy #: ______________
Relationship to camper: ____________________________________________________
I hereby give my permission for Emergency medial treatment in the event that I cannot
be reached. This also assures the academy that my child is in good physical condition and
health and may participate in all academies.